**3. Risk factors**

Important modifiable risk factors for developing carotid atherosclerotic disease include smoking, hypertension, dyslipidemia and poor glycemic control in diabetic patients. Smoking is strongly associated with development of carotid atherosclerotic disease whereby comparing age-matched non-smokers, former smokers and current smokers, the prevalence of clinically significant carotid stenosis (>50%) was seen in 4.4%, 7.3% and 9.5% (P<0.0001), respectively. Treatment of hypertension has been associated with reduced risk of developing carotid stenosis and stroke. For every 20mmHg increase in systolic blood pressure the odds ratio of developing moderate carotid stenosis is 2.11. Additionally, every 10mg/dL increase in serum cholesterol level was associated with an odds ratio of 1.10 for developing hemodynamically significant carotid stenosis. Strict control of postprandial glucose levels in diabetic patients has been associated with a reduction of carotid intimal media thickness and may also help to reduce the incidence of stroke from carotid stenosis [6].
